September 2016

Illustration by David Cutler

Clearing the air about climate change

Climate change is a public health issue, and physicians should be aware of the potential medical consequences and be able to communicate those to patients.

Fibromyalgia characterized by controversy

There is very clear, objective evidence that fibromyalgia is a real problem. But there remains considerable dissent among the medical community about the condition's cause.

Digging into the causes and fixes of resistant hypertension

An enduring challenge is figuring out why patients appear to have resistant hypertension and how to cure them of it.

System-wide changes improve diabetes care

To improve metrics of diabetes care, 4 employed primary care practices at a health system in Texas worked to systematically improve HbA1c testing and started a “Saving Toes” campaign.

GME needs serious financial and structural reform

The current system and critical elements of undergraduate and graduate medical education are in need of serious financial and structural reform.

Making MACRA better, in intent and implementation

The Medicare Access and CHIP Reauthorization Act makes significant improvements in how Medicare links payment to reporting of quality measures. Will CMS actually implement the law in a way that truly simplifies reporting?.

Integrating routine HIV screening into practice

Routine screening has 2 main benefits: diagnosing HIV infection before patients become symptomatic and have lost the bulk of their immune system and preventing HIV transmission.

New insulin questioned; carbon emission price proposed

Readers address insulin dosing and propose going further on climate change.

Climate change and clinical practice

This issue covers such topics as how internists can address climate health issues in their practice, what internists can do for patients with fibromyalgia, and how to identify and manage resistant hypertension.

Recalls for oral docusate sodium, INR monitoring system

This column reviews a recall of an oral liquid docusate sodium solution because of contamination and of an international normalized ratio monitoring system because it may provide significantly lower results than another method.

New overtime rules take effect December 2016

New overtime pay rules will affect employees whose annual salary is less than $47,476 and who work more than 40 hours per week.

ACP's new EVP/CEO talks burnout prevention, future focus

Darilyn Moyer, MD, FACP, ACP's first female EVP/CEO, addresses her plans for the organization, the evolution of health care, and how her experience will guide her efforts.

Candidates announced for Board of Governors Chair-elect Designee

George M. Abraham, MD, MPH, FACP, and Gregory C. Kane, MD, FACP, are seeking election as Chair-elect Designee of the Board of Governors. The Governors will be casting ballots next month, and the results will be announced in late October.

MKSAP Quiz: Worsening thrombocytopenia

A 35-year-old woman is evaluated for worsening thrombocytopenia; she is pregnant at 36 weeks' gestation. Medical history is significant for immune thrombocytopenic purpura. Previous platelet counts during this pregnancy have been 80,000 to 100,000/##mu;L (80-100 x 109/L). Her only medication is a prenatal vitamin. Following a physical exam and lab results, what is the most appropriate management of this patient's thrombocytopenia?.

Chapter awardees

Chapters honor Members, Fellows, and Masters of ACP who have demonstrated by their example and conduct an abiding commitment to excellence in medical care, education, research, or service to their community, their chapter, and ACP.